NPI | 1306395058 |
---|---|
Entity Type | Organization |
Authorized Contact | NURAH JAHAN ABDUR-RAHMAN Credentialing Coordiantor 718-636-4500 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 058667) |
Enumeration Date | 2016-09-22 |
Last Update Date | 2016-09-22 |